In hospital nursing homes, it is common to provide bed rails that extend above the mattress level to prevent patients from rolling out of the bed. Known bed rails may either pivot away or move slidably downward to allow a patient to get out of bed or for hospital staff to care for the patient.
Recently, concerns have been raised regarding the needs for bed rails in view of the possible safety hazards. It has been recorded that patients have become asphyxiated between the bed rail and the side of the mattress as shown in FIG. 1 or in the triangular space created by the right angle of the bed rail and headboard when the mattress corner curves. This gap allows patients to bury their face against the mattress as their body slips downward. Trapped persons in this position do not have anything to grab to pull themselves upward, and one arm is usually pinned under their body. This is especially problematic for bed-ridden patients who are too weak to pull themselves from the gap.
It has also been reported that patients may slide either on their abdomen or on their back through the slot between head and foot rails. This results in the patient becoming lodged between the space between the rails and the bedframes. As a result, their body is trapped in an inverted position with their head and neck jammed into a hyper-flexed or hyper-extended position by the floor.
One sure way to prevent the aforementioned problems is to develop standards for beds, rails, and mattresses as an integrated and total system for hospital care. Studies have revealed that the key dimensions of beds, rails, and mattresses vary greatly. This results in spacing between the head and foot rails of between 15-33 centimeters. Studies have shown that gaps of 6 centimeters maximum are needed to prevent death or severe injury from the examples noted above. It will also be appreciated that mattress thicknesses vary by as much as 5 centimeters and that mattresses become softer with age and shrink during refurbishing. Moreover, one-quarter of mattresses are replaced each year, whereas a bed lasts for 20 years. Accordingly, mattresses are often purchased from companies other than the bed manufacturer. Since there are more than 100 manufacturers of beds and side rails in the United States market, this problem is quite prominent. The non-specific relationship of mattresses, rails, and bedframes and variations in sizes of these items, allows the lateral distance from the mattress to the rails and headboard and the vertical distance from the mattresses to the top of the rails to vary widely.
Some other attempts at preventing entrapment include bolsters or long pillows that sit up on the mattress adjacent the bed rail. Unfortunately, this does not prevent the patient from becoming lodged between the bolster and the mattress. It also common for these pillows or bolsters to be placed on the floor during care of the patient and thus, the mattress becomes contaminated and must be cleaned.